Name of the Procedure:

Combined Right Heart Catheterization and Retrograde Left Heart Catheterization, for Congenital Cardiac Anomalies

Summary

This combined procedure involves threading catheters through blood vessels to measure pressures and take images of the heart’s right and left sides. It's crucial for diagnosing and treating congenital heart defects.

Purpose

This procedure is done to diagnose congenital heart anomalies, understand the heart’s function, and plan specific treatments or surgeries. The goal is to get a detailed look at the heart’s structure and blood flow.

Indications

• Symptoms like shortness of breath, chest pain, or palpitations.
• Diagnosed congenital heart conditions needing further evaluation.
• Poor growth and cyanosis in pediatric patients.

Preparation

• Fast for at least 6-8 hours prior.
• Inform the doctor of all medications; some may need to be paused.
• Pre-procedure tests may include blood work, chest X-rays, or an ECG.

Procedure Description

1. The patient lies on an X-ray table and is connected to monitors.
2. Sedation or anesthesia is administered.
3. A catheter is inserted through a vein in the groin or neck for right heart catheterization.
4. Another catheter is inserted through an artery for retrograde left heart catheterization.
5. Catheters are guided to the heart, with images and pressure readings taken.
6. Contrast dye may be injected to visualize blood flow.

Duration

The procedure typically takes 1 to 2 hours.

Setting

Performed in a hospital’s catheterization lab (cath lab).

Personnel

• Cardiologist
• Cardiac catheterization lab technologists
• Anesthesiologist or sedation nurse
• Nursing staff

Risks and Complications

• Common: Bruising or bleeding at the insertion site.
• Rare: Infection, arrhythmias, blood vessel damage, heart attack, stroke.
• Management includes immediate intervention for serious complications.

Benefits

• Detailed diagnosis leading to targeted treatment.
• Can guide the need for surgical intervention.
• Improved understanding of the severity of the heart condition.

Recovery

• Patients are monitored for several hours post-procedure.
• Instructions include rest, avoiding strenuous activities, and watching for signs of infection.
• Follow-up appointments are usually required.

Alternatives

• Non-invasive imaging like echocardiography or MRI.
• Pros and cons: Non-invasive options have less risk but may not provide as detailed information.

Patient Experience

• Patients may feel pressure but generally no pain due to sedation.
• Some discomfort at insertion sites post-procedure.
• Pain management includes over-the-counter analgesics if necessary.